Allergy to specific drug Epinephrine

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Example metadata last updated 2017-08-06 10:15:50.709000 UTC

Approval Status: Withdrawn

  • Approval Status: Withdrawn
  • Example Task Force: 4/17/2014
  • SDWG: Withdrawn from consideration since not clinically relevant.

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Certification

Comments:

  • This is an example of a propensity to drug adverse event with information on multiple allergic reactions each with reaction severity. It was based upon discussion with Russ Leftwich and Lisa Nelson in coordination with Patient Care Committee. See DSTU 219 for update regarding act/code.

Custodian: John D'Amore jdamore@diameterhealth.com (GitHub: jddamore)

Full sample: Allergies in empty CCD

Example: download example view on GitHub

<section>
	<templateId root="2.16.840.1.113883.10.20.22.2.6.1"/>
	<templateId root="2.16.840.1.113883.10.20.22.2.6.1" extension="2015-08-01"/>
	<!-- Allergies (entries required) section template -->
	<code code="48765-2" codeSystem="2.16.840.1.113883.6.1"/>
	<title>Allergies, Adverse Reactions and Alerts</title>
	<text>
		<table>
			<thead>
				<tr>
					<th>Allergen</th>
					<th>Reaction</th>
					<th>Reaction Severity</th>
					<th>Documentation Date</th>
					<th>Start Date</th>
				</tr>
			</thead>
			<tbody>
				<tr ID="allergy6">
					<td ID="allergy6allergen">Epineprhine</td>
					<td>
						<content ID="allergy6reaction">Ventricular tachycardia</content>
						<br/>
						<content ID="allergy6reaction2">Tremor</content>
					</td>
					<td>
						<content ID="allergy6reactionseverity">Severe</content>
						<br/>
						<content ID="allergy6reactionseverity2">Moderate</content>
					</td>
					<td>Jan 4 2014</td>
					<td>Jan 3 2014</td>
				</tr>
			</tbody>
		</table>
	</text>
	<entry typeCode="DRIV">
		<act classCode="ACT" moodCode="EVN">
			<!-- ** Allergy problem act ** -->
			<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
			<templateId root="2.16.840.1.113883.10.20.22.4.30" extension="2015-08-01"/>
			<id root="4a2ac5fc-0c85-4223-baee-c2e254803974"/>
			<code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
			<statusCode code="active"/>
			<!-- This is the time stamp for when the allergy was first documented as a concern-->
			<effectiveTime>
				<low value="20140104123506+0500"/>
			</effectiveTime>
			<author>
				<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
				<time value="20140104"/>
				<assignedAuthor>
					<id extension="99999999" root="2.16.840.1.113883.4.6"/>
					<code code="207Q00000X" codeSystem="2.16.840.1.113883.6.101"
						codeSystemName="Health Care Provider Taxonomy" displayName="Family Medicine"/>
					<telecom use="WP" value="tel:555-555-1002"/>
					<assignedPerson>
						<name>
							<given>Henry</given>
							<family>Seven</family>
						</name>
					</assignedPerson>
				</assignedAuthor>
			</author>
			<entryRelationship typeCode="SUBJ">
				<observation classCode="OBS" moodCode="EVN">
					<!-- allergy observation template -->
					<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
					<templateId root="2.16.840.1.113883.10.20.22.4.7" extension="2014-06-09"/>
					<id root="4a2ac5fc-0c85-4223-baee-c2e254803974"/>
					<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
					<statusCode code="completed"/>
					<!-- This is the time stamp for the biological onset of the allergy. -->
					<!-- Just the year is shown since a specific month and date was not reported -->
					<effectiveTime>
						<low value="20140103"/>
					</effectiveTime>
					<!-- This specifies that the allergy is to a medication in contrast to other allergies (substance) -->
					<value xsi:type="CD" code="59037007" displayName="Drug intolerance (disorder)"
						codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
					<author>
						<templateId root="2.16.840.1.113883.10.20.22.4.119"/>
						<time value="20140104"/>
						<assignedAuthor>
							<id extension="99999999" root="2.16.840.1.113883.4.6"/>
							<code code="207Q00000X" codeSystem="2.16.840.1.113883.6.101"
								codeSystemName="Health Care Provider Taxonomy"
								displayName="Family Medicine"/>
							<telecom use="WP" value="tel:555-555-1002"/>
							<assignedPerson>
								<name>
									<given>Henry</given>
									<family>Seven</family>
								</name>
							</assignedPerson>
						</assignedAuthor>
					</author>
					<informant>
						<assignedEntity>
							<!-- This is a fictional OID and identifier for the patient. This should be adapted to local implementation -->
							<id root="2.16.840.1.113883.3.3208.101.2"
								extension="20130607100800-Patient1"/>
							<addr use="HP">
								<streetAddressLine>1111 StreetName St.</streetAddressLine>
								<city>Silver Spring</city>
								<state>MD</state>
								<postalCode>20901</postalCode>
								<country>US</country>
							</addr>
							<telecom value="tel:+1(301)111-1111" use="HP"/>
							<assignedPerson>
								<name>
									<given>Patient</given>
									<family>One</family>
								</name>
							</assignedPerson>
						</assignedEntity>
					</informant>
					<participant typeCode="CSM">
						<participantRole classCode="MANU">
							<playingEntity classCode="MMAT">
								<!-- RxNorm is used to report specific drug allergies. Note to use NDF-RT for drug classes -->
								<!-- Best practice is to report drug allergies at ingredient level (e.g. epinephrine) not at the adminsitration level (e.g. 0.3mL 0.5mg/mL Prefilled Syringe)-->
								<code code="3992" displayName="epinephrine"
									codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm">
									<originalText>
										<reference value="#allergy6allergen"/>
									</originalText>
								</code>
							</playingEntity>
						</participantRole>
					</participant>
					<entryRelationship typeCode="MFST" inversionInd="true">
						<observation classCode="OBS" moodCode="EVN">
							<!-- Reaction Observation template -->
							<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
							<templateId root="2.16.840.1.113883.10.20.22.4.9" extension="2014-06-09"/>
							<id root="0506c036-adfb-4e6e-b9e1-eea76177ead5"/>
							<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
							<text>
								<reference value="#allergy6reaction"/>
							</text>
							<statusCode code="completed"/>
							<effectiveTime>
								<low value="20140103"/>
								<high nullFlavor="NA"/>
							</effectiveTime>
							<value xsi:type="CD" code="25569003" codeSystem="2.16.840.1.113883.6.96"
								codeSystemName="SNOMED CT" displayName="Ventricular tachycardia"/>
							<entryRelationship typeCode="SUBJ" inversionInd="true">
								<observation classCode="OBS" moodCode="EVN">
									<!-- Severity Observation template -->
									<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
									<templateId root="2.16.840.1.113883.10.20.22.4.8"
										extension="2014-06-09"/>
									<code code="SEV" codeSystem="2.16.840.1.113883.5.4"
										codeSystemName="ActCode"/>
									<text>
										<reference value="#allergy6reactionseverity"/>
									</text>
									<statusCode code="completed"/>
									<value xsi:type="CD" code="24484000"
										codeSystem="2.16.840.1.113883.6.96"
										codeSystemName="SNOMED CT" displayName="Severe"/>
								</observation>
							</entryRelationship>
						</observation>
					</entryRelationship>
				</observation>
			</entryRelationship>
			<!-- Note that multiple reactions may be recorded to the same substance ([0..*] -->
			<entryRelationship typeCode="MFST" inversionInd="true">
				<observation classCode="OBS" moodCode="EVN">
					<!-- Reaction Observation template -->
					<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
					<templateId root="2.16.840.1.113883.10.20.22.4.9" extension="2014-06-09"/>
					<id root="fea0b775-f3fe-4e0a-9c4f-4a5c235c2af0"/>
					<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
					<text>
						<reference value="#allergy6reaction2"/>
					</text>
					<statusCode code="completed"/>
					<effectiveTime>
						<low value="20140103"/>
						<high nullFlavor="NA"/>
					</effectiveTime>
					<value xsi:type="CD" code="26079004" codeSystem="2.16.840.1.113883.6.96"
						codeSystemName="SNOMED CT" displayName="Tremor"/>
					<entryRelationship typeCode="SUBJ" inversionInd="true">
						<observation classCode="OBS" moodCode="EVN">
							<!-- Severity Observation template -->
							<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
							<templateId root="2.16.840.1.113883.10.20.22.4.8" extension="2014-06-09"/>
							<code code="SEV" codeSystem="2.16.840.1.113883.5.4"
								codeSystemName="ActCode"/>
							<text>
								<reference value="#allergy6reactionseverity2"/>
							</text>
							<statusCode code="completed"/>
							<value xsi:type="CD" code="6736007" codeSystem="2.16.840.1.113883.6.96"
								codeSystemName="SNOMED CT" displayName="Moderate"/>
						</observation>
					</entryRelationship>
				</observation>
			</entryRelationship>
		</act>
	</entry>
</section>
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